Joe McKinsey spent about 25 years abusing drugs and alcohol, and followed that by 30 more stumping for sobriety.
When the 69-year-old Amagansett resident opened The Dunes East Hampton in December 2010, he fulfilled a goal to bring addiction treatment to wealthy clients, including high-income business people, on Long Island. Treatment costs $50,000 a month -- no insurance accepted.
Drugs are an equal opportunity scourge whose grip on Long Islanders has been growing. As tough new controls squeeze the prescription drug black market, police and other experts say Long Island drug abusers are migrating to heroin, which killed 241 people in 2012 and 2013, the highest two-year total ever, according to county records. Combined, heroin and prescription opiates killed almost 300 on Long Island in 2013.
More than a quarter million people sought treatment in New York State for drugs or alcohol in 2013, according to federal data. Experts say alcohol and drugs can exert a powerful hold on executives facing intense competitive pressures.
The Dunes isn't the only treatment facility on the East End.
For instance, about 30 miles west, the Seafield Center pursues a more traditional rehab regimen at a 90-bed facility in Westhampton Beach. The facility, which charges about $17,000 per month and takes insurance, is more strict about insisting that business affairs not intrude upon treatment.
No matter what the approach, experts say it's difficult to measure the effectiveness of addiction treatment facilities. In one of the few attempts at quantifying relapse rates, an October 2000 paper in The Journal of the American Medical Association said researchers found only about 40-60 percent of addicts were continuously abstinent a year after discharge from rehab.
Dr. David Gastfriend, chief executive of the Philadelphia-based nonprofit Treatment Research Institute, acknowledged the problem. "There's no methodology for evaluating the quality of America's treatment programs," he said.
GOURMET FOOD, YOGA
The Dunes offers to smooth the road to recovery for executives.
Residents at the 11-bed treatment center -- inspired by facilities like California's Promises Treatment Centers -- dine on gourmet food, do yoga and participate in equine therapy, in which horses' sensitivity to human moods is used to highlight clients' emotional swings. The facility uses multiple approaches to treatment at the secluded 4-acre compound, mixing counseling and a 12-step program with techniques like acupuncture. The minimum stay is a month.
At Dunes, as at Promises, famous for treating celebrities such as Charlie Sheen and Lindsay Lohan, patients come from up the road or as far as Moscow.
A 40-year-old Glen Head lawyer who describes himself as a "suspenders-and-$10,000-suit guy," said Dunes residents during his monthslong tenure were "actors, famous musicians, Wall Street billionaires ... all there for the same purpose and ... all equal in that purpose."
A particular draw for business executives: Policies allowing access to computers and telephones for work and sober minders -- companions assigned to avert substance abuse -- for off-site business meetings.
The Dunes' "community integration model" also allows group walks around town or an off-site lunch with family members, though a urine test may await on return. That contrasts with the approach at centers that restrict movement and curb access to cellphones and computers.
Levittown native Kevin Damm, a sober coach, said the standard regimen requires addicts to focus on recovery and "keep your head where your feet are."
But Dunes executive director Nicholas Kardaras, a psychotherapist who has a doctorate in psychology and a master's degree in social work, argued that the traditional "plastic bubble" rehabilitation model puts recovering addicts in peril once they re-enter society and discover "life comes at them at 100 miles per hour."
To ease the transition from residential rehab to work and home, some business executives turn to Damm and other sober companions.
Patty Powers, a Manhattan-based sober coach featured in the reality TV show "Relapse," said that Long Island executives sometimes hire her for one-on-one counseling before commuting home to help them get past happy hour. "We might spend one hour in a park or restaurant where we're talking. We might spend another hour in a gym."
What distinguishes business executives in rehab? Damm and Powers said the single-mindedness and authority that propel an executive to the top can be a two-edged sword.
"With gazillions of dollars at stake, you can't have cracks in your armor," Powers said.
Another Dunes alumnus, who stayed at the facility for 70 days, was a hard-driving entertainment executive. "You're so juiced by it, the career itself is a drug," he said. He left that business after a quarter century and filled the void with vodka, cocaine and oxycodone.
"I wound up being a human garbage can," said the Suffolk County resident, now in The Dunes outpatient program.
He tried to stop on his own. "I kept thinking: 'I can control this,'" he said.
When he did seek help, Alcoholics Anonymous didn't click.
"All I saw was people I couldn't relate to," he said. But The Dunes' meditation, nature walks and art sessions provided prospective.
Not all treatment facilities endorse making allowances for business.
Mark Epley, Seafield's CEO, said the facility offers some flexibility for urgent business, but "for the most part, we tell people to take care of their issues [before entering] so you can focus on your treatment." Epley also serves as mayor of Southampton village.
For Cory Bataan, 42, of Bellmore, drug treatment at Seafield came none too soon. His recreational drug use in high school turned more serious when he graduated college and became a stock broker.
"You live a fast life," he said.
Bataan told himself that he would stop when he got married, that he would stop when he had a child. He didn't. A $20-a-day cocaine habit grew to $400 a day. "From 2000 to 2005 I was unemployable," he said. "I couldn't deliver pizza without getting into trouble."
He entered Seafield and a 12-step program in 2005 and three years later returned to the securities business. Dealing with his addiction, Bataan said, had a profound impact. "When I got better, my wife got better, my kids got better."
Epley said facilities should provide tools to stay sober and re-engage should clients fall off the wagon.
McKinsey said The Dunes should be judged based on a patient's sobriety at least five years after treatment.
There is some local opposition to The Dunes, which is involved in a zoning dispute with the Town of East Hampton. The town's Zoning Board of Appeals voted 4-1 last year to revoke the $5 million facility's eligibility for residential zoning. McKinsey filed a lawsuit in response in U.S. District Court for the Eastern District of New York, charging discrimination against The Dunes' clients. Dunes attorney Joseph Campolo said settlement talks with the town are ongoing; the town's attorney declined to comment.
While treatment methods may vary, there is clearly a market for rehab centers that cater to business executives and others who don't want to isolate themselves from the working world. McKinsey is scouting sites to plant Dunes-style rehab facilities in England and France.
The Glen Head lawyer who has received treatment at The Dunes said that, for him, connecting to work was crucial.
"I had access to conference calls," he said. "If I had to get to meetings, a sober companion was assigned to me ... If I go away for six months and no one can talk to me, I've lost my career."